scholarly journals Psychiatric Drug Prescription and Temporal Associations with a First Diagnosis of Gambling Disorder—Results from a National Register Study

2021 ◽  
Author(s):  
Carolina Widinghoff ◽  
Jonas Berge ◽  
Anders Hakansson
Keyword(s):  
Psychiatric Disorders ◽  
Gambling Disorder ◽  
Psychiatric Comorbidity ◽  
Drug Prescription ◽  
Poor Mental Health ◽  
Early Screening ◽  
Addictive Disorders ◽  
Period 2 ◽  
Specialized Care ◽  
First Diagnosis

AbstractPsychiatric comorbidity is common in gambling disorder (GD), but there are few studies on larger nationwide samples of treatment-seeking patients. Also, temporal associations between GD and other psychiatric disorders are often difficult to study. To address the prevalence and the temporal associations of prescriptions for psychiatric disorders — both in specialized care and primary care — in patients with a GD diagnosis (ICD-10 F63.0). Data was derived from national health registers in Sweden. All patients who were diagnosed with GD in specialized health care in 2005–2016 were included and run against the nationwide database on prescription of pharmaceuticals aimed for psychiatric disorders (n = 2018). Prevalence of psychiatric drug prescription was used as a proxy for psychiatric comorbidity and studied for two 2-year periods (period 1 and 2) prior to GD and one 2-year period (period 3) after the diagnosis. Controlling for gender, age, and time periods, for eight drug categories (anti- epileptics, anti-psychotics, benzodiazepine derivatives, anxiolytics, hypnotics, anti- depressants and drugs used in addictive disorders), significant increases in drug prescription were seen. For central stimulants, a significant increase was seen upon receiving the GD diagnosis (from period 2 to 3), and for benzodiazepines, an increase was seen prior to the GD diagnosis (from period 1 to 2), but not upon diagnosis (from period 2 to 3). Psychiatric comorbidity in GD is common. Drug prescription for psychiatric problems increased markedly in the years temporarily associated with a first diagnosis of GD. The findings may call for early screening for problem gambling in patients with treatment contacts for increasingly poor mental health.

Psychiatric Comorbidity in the Evolution From Migraine to Medication Overuse Headache

Cephalalgia ◽  
2005 ◽  
Vol 25 (7) ◽  
pp. 519-522 ◽  
Author(s):  
F Radat ◽  
C Creac'h ◽  
JD Swendsen ◽  
M Lafittau ◽  
S Irachabal ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Odds Ratio ◽  
Psychiatric Comorbidity ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Anxiety And Depression ◽  
Psychoactive Substances ◽  
Addictive Disorders ◽  
Substance Related Disorders

We set out to study the role of psychiatric comorbidity in the evolution of migraine to medication overuse headache (MOH) by a comparative study of 41 migraineurs (MIG) and 41 patients suffering from MOH deriving from migraine. There was an excess risk of suffering from mood disorders [odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.5, 13.5], anxiety (OR = 5, 95% CI 1.2, 10.7) and disorders associated with the use of psychoactive substances other than analgesics (OR = 7.6, 95% CI 2.2, 26.0) in MOH compared with MIG. Retrospective study of the order of occurrence of disorders showed that in the MOH group, psychiatric disorders occurred significantly more often before the transformation from migraine into MOH than after. There was no crossed-family transmission between MOH and psychiatric disorders, except for substance-related disorders. MOH patients have a greater risk of suffering from anxiety and depression, and these disorders may be a risk factor for the evolution of migraine into MOH. Moreover, MOH patients have a greater risk of suffering from substance-related disorders than MIG sufferers. This could be due to the fact that MOH is part of the spectrum of addictive disorders.

scholarly journals Psychiatric Comorbidity and Economic Hardship as Risk Factors for Intentional Self-Harm in Gambling Disorder—A Nationwide Register Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Karlsson ◽  
Olivia Hedén ◽  
Helena Hansson ◽  
Jenny Sandgren ◽  
Anders Håkansson
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Social Welfare ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Gambling Disorder ◽  
Psychiatric Comorbidity ◽  
Economic Hardship ◽  
Self Harm ◽  
Welfare Payment

Background: There is an increased risk of suicidality in gambling disorder (GD) and economic hardship is common in the population. Economic hardship itself is a risk factor for suicidality. This study aims to explore the risk of intentional self-harm in GD utilizing social welfare payment (SWP) as a proxy for economic hardship and exploring how economic hardship, gender, criminality, socioeconomic-, and psychiatric risk factors might contribute to intentional self-harm in GD.Methods: This is a nationwide register-based study of 848 individuals diagnosed with GD in the Swedish healthcare system during the years of 2011–2014 with an average follow up of 4.9 years. Pearson's Chi-square analyses were carried out for comparisons regarding psychiatric comorbidity and intentional self-harm with regards to gender and SWPs. Univariable and multivariable Cox regression were utilized to analyse risk factors for intentional self-harm.Results: A large part of the study population received SWPs (45.5% with an insignificant overrepresentation of women) and psychiatric disorders were more common in these individuals (p < 0.001). Conviction for crime in general (p < 0.001) as well as intentional self-harm (p = 0.025) were also more common amongst recipients of SWPs. Criminal conviction in general was abundant (26.5%). In the stepwise multivariable regression, substance-related diagnoses as well as anxiety, depressive, and personality disorders remained risk factors for intentional self-harm and no significant results were found with regards to gender, criminal history, or SWPs.Conclusions: Social welfare payment was common among GD patients and intentional self-harm was more common amongst recipients than GD patients as a whole. Social welfare payments were however not a significant risk factor for intentional self-harm. However, attention to suicidality and self-injurious behavior should be paid from social services controlling SWPs due to the large prevalence of intentional self-harm in this group. In accordance with previous studies, comorbid psychiatric disorders such as anxiety, depression, substance use, and personality disorders increased the risk of intentional self-harm.

scholarly journals Increased risk for developing gambling disorder under the treatment with pramipexole, ropinirole, and aripiprazole: A nationwide register study in Sweden

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252516
Author(s):  
Mirjam Wolfschlag ◽  
Anders Håkansson
Keyword(s):  
Odds Ratio ◽  
Gambling Disorder ◽  
Drug Prescription ◽  
Reward System ◽  
Future Research ◽  
Swedish Population ◽  
Dopaminergic Drugs ◽  
Addictive Disorders ◽  
Dopaminergic Medication ◽  
Increased Risk

Gambling Disorder (GD) has recently been reclassified from an impulse-control disorder to a behavioural addiction and, as in other addictive disorders, the dopaminergic reward system is involved. According to neuroimaging studies, alterations within the striatal dopaminergic signalling can occur in GD. However, the findings to date are controversial and there has been no agreement yet on how the reward system is affected on a molecular basis. Within the last 20 years, there has been growing evidence for a higher risk to develop GD in response to certain dopaminergic medication. Especially the dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole seem to increase the likelihood for GD. The goal of this study was to examine the association between a prescription for either of the three pharmaceuticals and a GD diagnosis in a large cross-sectional study of the Swedish population. Compared to patients with any other dopaminergic drug prescription (38.7% with GD), the diagnosis was more common in patients with a dopamine agonist prescription (69.8% with GD), resulting in an odds ratio of 3.2. A similar association was found between aripiprazole prescriptions and GD diagnoses, which were analysed within the subgroup of all patients with schizophrenia or a schizotypal, delusional, or another non-mood psychotic disorder. An aripiprazole prescription increased the likelihood of GD (88.8%) in comparison to patients without an aripiprazole prescription (71.2%) with an odds ratio of 3.4. This study contributes to the increasingly reliable evidence for an association between several dopaminergic drugs and a higher risk for developing GD. Therefore, one future research goal should be a better understanding of the neurobiology in GD to be able to design more selective dopaminergic medication with less severe side effects. Additionally, this knowledge could enable the development of pharmacotherapy in GD and other addictive disorders.

scholarly journals Psychiatric comorbid disorders of cognition: a machine learning approach using 1175 UK Biobank participants

2020 ◽  
Vol 23 (4) ◽  
pp. 140-145
Author(s):  
Chenlu Li ◽  
Delia A Gheorghe ◽  
John E Gallacher ◽  
Sarah Bauermeister
Keyword(s):  
Machine Learning ◽  
Cognitive Decline ◽  
Psychiatric Disorders ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Imaging Study ◽  
Cognitive Change ◽  
Poor Mental Health ◽  
Uk Biobank

BackgroundConceptualising comorbidity is complex and the term is used variously. Here, it is the coexistence of two or more diagnoses which might be defined as ‘chronic’ and, although they may be pathologically related, they may also act independently. Of interest here is the comorbidity of common psychiatric disorders and impaired cognition.ObjectivesTo examine whether anxiety and/or depression are/is important longitudinal predictors of cognitive change.MethodsUK Biobank participants used at three time points (n=502 664): baseline, first follow-up (n=20 257) and first imaging study (n=40 199). Participants with no missing data were 1175 participants aged 40–70 years, 41% women. Machine learning was applied and the main outcome measure of reaction time intraindividual variability (cognition) was used.FindingsUsing the area under the receiver operating characteristic curve, the anxiety model achieves the best performance with an area under the curve (AUC) of 0.68, followed by the depression model with an AUC of 0.63. The cardiovascular and diabetes model, and the covariates model have weaker performance in predicting cognition, with an AUC of 0.60 and 0.56, respectively.ConclusionsOutcomes suggest that psychiatric disorders are more important comorbidities of long-term cognitive change than diabetes and cardiovascular disease, and demographic factors. Findings suggest that psychiatric disorders (anxiety and depression) may have a deleterious effect on long-term cognition and should be considered as an important comorbid disorder of cognitive decline.Clinical implicationsImportant predictive effects of poor mental health on longitudinal cognitive decline should be considered in secondary and also primary care.

scholarly journals Peripartum depression in parents with multiple sclerosis and psychiatric disorders in children

2016 ◽  
Vol 22 (14) ◽  
pp. 1830-1840 ◽  
Author(s):  
Neda Razaz ◽  
Helen Tremlett ◽  
Ruth Ann Marrie ◽  
K.S. Joseph
Keyword(s):  
Multiple Sclerosis ◽  
Cohort Study ◽  
Confidence Interval ◽  
Psychiatric Disorders ◽  
Physician Visit ◽  
Drug Prescription ◽  
P Value ◽  
Potential Association ◽  
Unaffected Parent ◽  
Peripartum Depression

Background: Although many individuals with multiple sclerosis (MS) experience depression, there are no studies on the frequency and effect of peripartum depression among parents with MS. Objective: To examine the frequency of peripartum depression in individuals with MS and its potential association with children’s psychiatric disorders. Methods: We conducted a cohort study in British Columbia, Canada, using linked health databases, of parents with MS and their children, and age-matched unaffected parent–child dyads. The diagnosis of peripartum depression, MS and psychiatric disorders in children was based on information from hospital admission, physician visit and drug prescription claims. Results: Peripartum depression was significantly more common among MS parents ( n = 360) versus unaffected ( n = 1207) parents (25.8% vs 18.5%, p value 0.02), especially among MS affected fathers versus unaffected fathers (25.7% vs 10.2%, p value < 0.001). The incidence of psychiatric disorders in children was 3.3 and 2.7 per 100 child-years among children with and without an MS parent, respectively. The rate of psychiatric disorders was significantly higher in children with an MS parent (vs without, hazard ratio (HR): 1.34; 95% confidence interval (CI): 1.03–1.74) and among children with parents who had peripartum depression (HR: 1.87; 95% CI: 1.36–2.55). Conclusion: Parental MS is associated with a higher risk of peripartum depression and increases the risk of psychiatric disorders in children.

ADHD and addictive disorders: What links?

2015 ◽  
Vol 30 (S2) ◽  
pp. S28-S28
Author(s):  
M. Fatseas
Keyword(s):  
Substance Use ◽  
Psychiatric Disorders ◽  
Adult Adhd ◽  
Age At Onset ◽  
Addictive Disorders ◽  
Increased Risk ◽  
High Prevalence ◽  
Complicated Course ◽  
Comprehensive Search ◽  
Relationship Of

The links between ADHD and addictive disorders have been the subject of a large number of studies showing a high prevalence rate of ADHD in substance abusing populations as well as an increased risk of substance use disorder (SUD) in ADHD patients that may be independent of other psychiatric conditions. High prevalence of ADHD has also been highlighted among individuals suffering from other addictive disorders such as pathological gambling. Adequate diagnosis of ADHD in SUD patients is challenged by phenomenological aspects of addiction and by frequently associated other psychiatric disorders that overlap with key symptoms of ADHD. A detailed comprehensive search for child and adult symptoms including the temporal relationship of ADHD, substance use and other psychiatric disorders should maximize the validity and the reliability of adult ADHD diagnosis in this population. Further, a follow-up evaluation of ADHD symptoms during treatment of SUD may reduce the likelihood of misdiagnosis. Finally, it should be noticed that when SUD occurs with ADHD, it is associated with a greater severity of SUD compared to other SUD patients. This has been shown with an earlier age at onset, antisocial behavior, risk for depression, chronicity of substance use, need for hospitalization and likelihood of a complicated course. Recent data suggest that the effects of ADHD on SUD outcomes are independent of other psychiatric comorbidities. This highlights the need of an earlier implementation of preventive interventions for substance use or behavioral addiction in children/adolescents with ADHD and the necessity to consider this disorder in the treatment of addictive disorders. Benefices and risk of MPH in adult patients with addiction and ADHD are discussed.

scholarly journals Relationship of psychiatric comorbidity and treatment of panic disorder and agoraphobia

2006 ◽  
Vol 134 (7-8) ◽  
pp. 267-272
Author(s):  
Milan Latas ◽  
Vladan Starcevic ◽  
Goran Trajkovic
Keyword(s):  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Psychiatric Comorbidity ◽  
Integrative Model ◽  
Treatment Modalities ◽  
Cognitive Behavior ◽  
Comorbid Psychiatric Disorders ◽  
Relationship Of

Introduction. Besides numerous studies that examined various aspects of comorbidity in patients with panic disorder and agoraphobia and numerous studies that examined efficacy of different treatment modalities in these patients, there was no study that examined relationship of overall psychiatric comorbidity and treatment of patients with panic disorder and agoraphobia. Objective. The objective of the study was to establish the effect of psychiatric comorbidity on treatment efficiency of patients with panic disorder and agoraphobia. Method. The sample of the study consisted of 119 patients with primary diagnosis of panic disorder and agoraphobia. The therapy of patients was based on the use of individual integrative model of treatment, which incorporated psycho-pharmaceuticals (benzodiazepines and antidepressants) and cognitive- behavior therapy. Symptom severity was estimated by Panic and Agoraphobia Scale before and after the completion of treatment. Patients with comorbidity and patients without any comorbidity were compared by MANOVA and ANOVA with repeated measures. Results. The results of the study showed that 91% of patients met diagnostic criteria of comorbid psychiatric disorder and these patients had more severe clinical picture than patients without any comorbid disorder before the treatment. The results also showed that, after the completion of treatment, there was a significant reduction of all analyzed symptoms, that the effects of treatment were significantly better in patients with psychiatric comorbidity and that comorbid psychiatric disorders had no negative effect on the main goals of the treatment. Conclusion. Based on these results, it may be concluded that: in patients with panic disorder and agoraphobia and comorbid psychiatric disorders, the pharmacotherapy must be based on simultaneous use of antidepressants and benzodiazepines, while standard cognitive-behavior therapy of patients with panic disorder and agoraphobia must be modified in case of the existing comorbid psychiatric disorders.

Attention-deficit hyperactivity disorder in adults

2016 ◽  
Vol 10 (3) ◽  
pp. 165-172 ◽  
Author(s):  
Rakesh Magon
Keyword(s):  
Mental Health ◽  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Psychiatric Comorbidity ◽  
Clinical Presentation ◽  
Health Condition ◽  
Mental Health Condition ◽  
Hyperactivity Disorder ◽  
Role Impairment

Attention-deficit hyperactivity disorder (ADHD) is one of the most-common psychiatric disorders; it is highly comorbid with many other psychiatric disorders and associated with substantial role impairment. Untreated ADHD results in psychiatric comorbidity, relationship and parenting problems, underachievement, frequent job losses, and opportunistic delinquency. Nevertheless, ADHD remains the most under-recognised and undertreated mental health condition in adults. This article discusses the clinical presentation of ADHD in adulthood with a particular focus on recognition, assessment and management of ADHD in adults in primary care.

What Are the Psychosocial Factors Associated With Migraine in the Child? Comorbid Psychiatric Disorders, Family Functioning, Parenting Style, or Mom’s Psychiatric Symptoms?

2018 ◽  
Vol 33 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Gozde Kandemir ◽  
Selma Tural Hesapcioglu ◽  
Aysegül N. Citak Kurt
Keyword(s):  
Psychiatric Disorder ◽  
Family Functioning ◽  
Psychiatric Disorders ◽  
Parenting Style ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Treatment Plan ◽  
Depression And Anxiety ◽  
Factors Associated ◽  
Migraine Group

Objective: Psychiatric diagnoses, parenting style, family functioning among children and adolescents with migraine, and psychiatric symptoms of their mothers were examined. Methods: The K-SADS and other measurements were used to assess psychiatric disorders in 50 children with migraine (aged 8-18) and matched 50 controls. Results: At least one psychiatric disorder was diagnosed in 56% of the migraine group. The presence of any psychiatric disorder in children (odds ratio [OR] = 2.765, P = .027) and somatization symptoms in their mothers (OR = 2.061, P = .025) were increasing the risk of migraine diagnosis. The parenting style scale assessments revealed that parents in the migraine group grant their children less autonomy. Conclusion: Psychiatric comorbidity, especially depression and anxiety disorders, is more common in children with migraine. The frequency of eating disorder is also higher. Evaluating comorbidity, family functioning, and particularly affective responsiveness in migraine families may guide the clinician to a targeted treatment plan.

Addictions: Gambling

2016 ◽  
Author(s):  
Lia Nower ◽  
Kyle Caler
Keyword(s):  
Social Workers ◽  
Gambling Disorder ◽  
Ad Hoc ◽  
Significant Proportion ◽  
The United States ◽  
Health Concern ◽  
Addictive Disorders ◽  
Significant Public Health Concern ◽  
Assessment And Treatment ◽  
Significant Public Health

Gambling disorder is a significant public health concern. The recent and continued proliferation of land-based and interactive gambling opportunities has increased both accessibility and acceptability of gambling in the United States and abroad, resulting in greater and more varied participation. However, there is currently no designated federal funding for prevention, intervention, treatment, or research, and states are left to adopt varying standards on an ad hoc basis. Social workers receive little or no training in screening or treating problem gamblers, though research suggests that a significant proportion of those with mental health and other addictive disorders also gamble excessively. Raising awareness about the nature and scope of gambling disorder and its devastating implications for families and children is a first-step toward integrating gambling into prevention, assessment and treatment education in social work. This, in turn, will increase the chances of early identification and intervention across settings and insure that social workers can lend a knowledgeable and credible voice to addressing this hidden addiction.

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